7.29.2013

I
haven’t personally assessed Bob Filner, however, from my desk, and in the diagnostic world, Filner
would probably fall in the Axis II category, somewhere along the Personality Disorder
continuum.

Maybe
he’s a Narcissist. Those gents (not always men) cannot imagine that their wily
ways are not supremely wonderful. Bill Clinton was often lay-diagnosed as a Narcissist. Narcissists aren’t always bad, and in fact, their chi pushes the world forward. Only
humongous egos would think, “I’m going to do something that no other human
being has ever done before…invent a hand held computer,” or, bring back Irish
dancing for one billion people to enjoy!

Women can be Narcissists too, but
they are less professionally and culturally tolerated. Somehow, really large confidence is
seen more jocular in ambitious men. Of importance related to Filner,
Narcissists will not see the error of their ways. The guy on his 11th
DUI still blaming “the law” (true story) is colossal denial. Narcissism is more
than denial – it’s more than an individual with an external locus of control
(blaming outside forces for one's station in life).

The
other Personality Disorders that may stick for Filner would be something like
Borderline Personality Disorder, or Antisocial Personality Disorder, formerly known as Sociopathy. There are dramatic differences
in those clinical diagnoses but what matters here is the treatment of choice
for a Personality Disorder.

The
Psychiatric community knows full-well that these Axes do not respond positively
to traditional psychotropic medication, leaving a treatment choice that falls along the same path that
we use to treat men who beat their wives (sociopaths)…”You cannot beat your
wife because you’ll go to jail” (an external consequence). The wife-beater
often doesn’t grasp that hitting his beautiful wife is disrespectful, unkind, and
ultimately damages the very foundation of intimacy and trust.

No, this man
psycho-educationally learns, like a mantra, that “hitting wife leads to jail
and I don’t wanna go there.” This is a first
order change and doesn’t require a deep psychic shift in perception.

Much
like the way we teach teenagers to drive, “Don’t speed or you’ll get a ticket.”
The more mature driver naturally learns, over time, with a developing brain and
experience that speeding increases the chances of harm to myself or others, the
risk outweighs the benefit, and may incur great cost to my person (a second order change).

In
Filner’s case, it’s reasonable to imagine that he can be taught, actually
learn, as one tediously learns how to say, fly a plane, the intrinsic
consequences of sexually advancing towards women. The mechanics of empathy can be taught, but that isn’t the real
goal. The real goal is behavioral, "You cannot be in a room alone with a woman." And with further psycho-education and rehabilitation, "No touching a woman without her verbal approval, after I ask."

Prisons are not concerned with teaching the mechanics of empathy to
inmates, and that seems to be a model that we culturally embrace, so, one could
say that the first order changes are sufficient to keep a safe and civilized
existence for our society. And, along those lines, the single most common
characterological flaw amongst the incarcerated is lack of impulse
control. “I want it. I’m taking it.” One can only assume that Filner's grossly unacceptable behavior was enabled by his co-horts (friends, family, colleagues).

As public allegations seem to read, Filner harassed and violated highly educated, well-resourced women. Has there ever been so many well-appointed yet frightfully quiet victims to one deviant?

Are there others like him, male or female? Of course there are.

Sexual
aggression is about power and control. It is not about physical gratification -
that’s easy to come by. Power and control are about using others as objects,
with no concern for reciprocity or mutual pleasure. If this sounds like a
retarded stage of development, reminiscent of toddlerhood, it precisely is. Toddlers learn through repetitive socialization, the curbing of Id, “Let’s ask her if we can share the shovel today? Oh, she says no. That’s ok,
let’s move on to the bucket and play over here. Maybe we can come back later.” Like the bull elephant running rough shod over the herd, until he's sent away at age 14; a growing teenager overpowering his tired mum, or the wolf mommy knocking back her pup as he attempts to steal her fresh meal - healthy ego formation is either going checked or unchecked - one million auto corrects.

7.27.2013

As a teenager, I suffered a near-drowning episode at The Wedge,in Newport Beach, in one of the largest September swells ever. Having loved the ocean and body boarding up until that point, I have since developed a fear and (healthy respect) of large bodies of water.

I recently faced my deep-sea fear, heading out on the half-day boat, Premier, with HM Landing, a highly recommended company in Point Loma.

It's always astonishing to watch a group of men over 50 starting their morning off with smoking, beer, and hot dogs (no lie - it was 7am). Being on a boat is a lot like being in a casino; time starts to feel like some man-made pretext. I can only imagine, a casino, on a boat.

But they were good-ol' boys and nice as could be. See one here...as proof.

Every time we do something that frightens us, and nothing bad happens, it's disconfirmation of our belief system. It's exposure to the anxiety-provoking stimuli, which, over time, wears away the traumatic memory. It's all G...

While we didn't come away with any great fish tales, we saw an amazing dolphin show (vid below).

7.22.2013

But doctors still don’t over-treat themselves. They see the consequences
of this constantly. Almost anyone can find a way to die in peace at
home, and pain can be managed better than ever. Hospice care, which
focuses on providing terminally ill patients with comfort and dignity
rather than on futile cures, provides most people with much better final
days. Amazingly, studies have found that people placed in hospice care
often live longer than people with the same disease who are seeking
active cures. I was struck to hear on the radio recently that the famous
reporter Tom Wicker had “died peacefully at home, surrounded by his
family.” Such stories are, thankfully, increasingly common.

To administer medical care that makes people suffer is anguishing.
Physicians are trained to gather information without revealing any of
their own feelings, but in private, among fellow doctors, they’ll vent.
“How can anyone do that to their family members?” they’ll ask. I suspect
it’s one reason physicians have higher rates of alcohol abuse and
depression than professionals in most other fields. I know it’s one
reason I stopped participating in hospital care for the last 10 years of
my practice.

Through a fluke of fate, my website has become a hangout for some amazing people, including men determined to wean themselves from porn. Their efforts have taught me more than I ever wanted to know about this subject. A few years ago one wrote,

I am sure that if a study were actually done with honest men, we would see correlation between porn viewing and erectile dysfunction.
The porn industry takes advantage of the uninformed public and makes
billions. Then the pharmaceutical companies sell us costly sexual
enhancement drugs to treat the side effects—and make billions.

I've
been looking at Internet pornography since I began college 13 years ago.
Around age 24, I noticed difficulty getting aroused with real women.
Generic Viagra off the Internet allowed me to have real relationships
with few problems until the age of 29. Then, it became increasingly
difficult to have real sex, even with the pills. Realizing
my problem, I tried several times to give up porn. The longest I lasted
without it was 3 weeks. During this time, I could not get aroused
thinking about normal sex, so the frustration built. My only escape was
to fall back into the only thing that would arouse me: fantasizing about
fetishes I developed when watching porn. Then it was back to porn. I
need to be cured of this.

7.18.2013

Children's Hospital L.A. program reaches out to teen dads

The L.A. Fathers Program aims to reach the
often forgotten partner in teen pregnancies, providing young dads with
free parenting and relationship classes, job placement and social
services.

Frank Mariano, 16, a
participant in the L.A. Fathers Program at Children's Hospital Los
Angeles, plays with his 1-year-old daughter, Anabell, in their Koreatown
home.
(Susannah Kay / Los Angeles Times / July 10, 2013)

By Stephen Ceasar, Los Angeles Times

July 13, 2013, 5:52 p.m.

Frank Mariano walked up the
block and made a right turn toward a group of carefree teenage boys who
spent the muggy summer day in Koreatown skateboarding and checking their
phones for text messages.

Frank approached the youths — who eyed him with puzzled
looks — but then the 16-year-old pushed a stroller into the playground
where he would spend the afternoon with Anabell, his 1-year-old
daughter.Frank would later leave the toddler with her 17-year-old mother and
head to Children's Hospital Los Angeles to meet with two dozen other
fathers — between the ages of 14 and 25 — to discuss their shared
struggles and to learn skills to help ease their lives.The L.A. Fathers Program at
the hospital is designed to reach the often forgotten partner in teen
pregnancies and dispel the stereotypes attached to the young men —
deadbeat, irresponsible or absent fathers.The voluntary program scours some of the poorest neighborhoods in Los
Angeles to find young fathers and provide them with free parenting and
relationship classes, job placement and social services. In about a
year, they've had nearly 250 teen fathers go through the program. They
receive free food, diapers and condoms for attending.It has developed into a haven where the young men feel safe to relax
and talk about the challenges they each face — and sometimes to vent
about their "baby mama," if needed."A lot of young dads feel alienated and experience a lot of judgment —
from their family, from their friends, at school," said Frank Blaney,
the program's coordinator. "Here, there are other dads that are going
through the same experience they are."The program, which began last summer, aims to help the young men
learn the skills to become responsible parents and be active in their
children's lives. The hospital has long had a similar program for
teenage mothers, and hospital officials recognized a need to reach young
fathers as well.The program includes 10 weekly classes on job skills training and
nonviolent parenting and relationship classes. Program coordinators find
the youths by reaching out to social workers, school counselors, and
mental health and probation offices. This year, they launched an ad
campaign on buses and trains around the city.During a recent class, Blaney asked participants to raise their hand
if they grew up without a father figure; nearly all raised their hands.He then asked what they were taught about what it means to be a man.
"Have a lot of women," said one. "Men don't cry," said another. "Control
your woman," someone said. Blaney explained that those are the
prevailing stereotypes — but men can be sensitive, loving, caring and
still be a man.Then one shouted: "Provide for your family!""That's right. There's the player — then there's the man who is at
home holding it down for his family," Blaney replied. "We can pick the
path we want to take as men."The pressure to immediately be providers, however, can be detrimental
in the long term, Blaney said. Often, teenage fathers immediately drop
out of school to get whatever work they can because they feel that a man
should be the breadwinner. They frequently get stuck in low-paying,
low-skilled jobs as a result. "It becomes a dead-end trap," Blaney said.The program stresses finishing high school and continuing their
education if possible — stressing the higher earning potential — and
helps them find jobs that can accommodate both."It's very difficult for most of these guys to have a long-term viewpoint," Blaney said. "They have such immediate needs."The program is funded by a three-year, $784,500 grant from the U.S.
Office of Family Assistance. For the funding to be renewed, officials
must demonstrate that they have been effective in getting participants
jobs. Blaney has been reaching out to local employers to explain that
the program involves young, highly motivated men who are looking for
work. "It's basically, 'Please — give our dads a chance,'" he said.Frank Mariano has been able to balance school and work. He continues
to go to high school and works in construction on days off. He hopes to
attend culinary school after graduation and become a chef. His
girlfriend, the mother of his child, recently graduated from high school
and will attend junior college in the fall."I put school before work," Frank said. "Without my education I won't be able to complete my goals."The class also saved his relationship, he said. In 2011, Frank said,
he was arrested on suspicion of domestic battery after a fight with his
girlfriend. He was put on probation.They argued often and lacked communication. It was a session with Ben
Wright, who conducts the parenting courses, that marked a change.Wright brought out two animal hand puppets — which always draws
skeptical laughter from the guys — each representing separate approaches
to parenting and relationships. The jackal represents an aggressive,
angry form of communication rife with criticism, judgment and blame. The
other puppet, a giraffe, represents cooperation and understanding. The
giraffe's heart, Wright explains, is large because it must pump blood
all the way up its neck to the brain.The fathers act out situations with each — demonstrating the hurtful
and long-lasting effects the jackal can have on their children and their
partners. "When I saw him take out the puppets I was like 'What the
hell?' " Frank said. "But after — he had a point."He added: "I'm more giraffe than jackal now."stephen.ceasar@latimes.com